Irregular periods: Differential Diagnosis by Symptom Pattern

• •Cycle, pregnancy status, and reproductive history
• •Pelvic pain pattern and bleeding profile
• •Urogenital symptoms with targeted examination

• •Character of pain and exertional trigger
• •Hemodynamic instability, pulse pattern, and blood pressure
• •ECG and cardiac biomarkers trend

• •Subacute/chronic course with metabolic trigger profile
• •Weight, appetite, and temperature regulation changes
• •Lab pattern consistency across repeated tests

• •Constitutional symptoms (weight loss, night sweats, fatigue)
• •Persistent or progressive pattern without clear acute trigger
• •Abnormal blood counts and imaging findings

• •Sudden vs progressive neurologic deficit
• •Focal deficits, consciousness changes, and meningeal signs
• •Headache phenotype and trigger pattern

Immediate testing when red flags are present

• •Focused examination with baseline labs if symptoms persist
• •Escalate to urgent workup when red flags appear

Group-directed workup

• •Pregnancy test when relevant
• •Pelvic / scrotal ultrasound
• •Urinalysis and STI tests
• •Hormonal panel when indicated
• •ECG
• •Troponin
• •Blood pressure in both arms
• •Echocardiography when indicated